A consecutive series of open compared to laparoscopic restorative proctocolectomy with ileo-pouch anal anastomosis for familial adenomatous polyposis

Abstract

We compared the intraoperative and early post-operative results of open (ORPC) and laparoscopic restorative proctocolectomy (LRPC) for familial adenomatous polyposis (FAP). We studied all our patients undergoing restorative proctocolectomy for FAP. The first 8 patients who underwent LRPC were prospectively studied and compared with the records of 27 patients who had undergone ORPC. Twenty-seven patients (5 males) and 8 patients (3 males) underwent ORPC and LRPC. The median length of time of surgery was 160 min (range 135–180 min) and 150 min (range 60–360 min) for LRPC and ORPC, respectively (P = ns). The median length of the wound was 8.5 cm (range 5–16 cm) and 25 cm (range 18–34 cm) for LRPC and ORPC, respectively (P < 0.0001). There was no significant differences in time to ileostomy function, first fluid intake or time to solid diet intake between the two groups. There was a significant improvement in hospital stay (median 7 days vs 10 days) in the LRPC group. Thus, LRPC may be performed with no significant increase in operative time compared to the open technique. Furthermore, the wound length is significantly shorter in LRPC and the time taken for hospital stay is significantly improved.